Provider Demographics
NPI:1649471137
Name:TOCHTERMAN, VIRGINIA H
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:H
Last Name:TOCHTERMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 W 34TH CT
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-3300
Mailing Address - Country:US
Mailing Address - Phone:850-527-8491
Mailing Address - Fax:
Practice Address - Street 1:318 W 34TH CT
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-3300
Practice Address - Country:US
Practice Address - Phone:850-527-8491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT7250225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLA004OtherTRI-CARE
FLX1488OtherBCBS